Random vs. blocked perturbation training on reactive balance control in peripheral neuropathy: A protocol study for a...

Area of Science:

• Neurology
• Motor Control
• Exercise Physiology

Background:

• Diabetic peripheral neuropathy (DPN) significantly impairs reactive balance control.
• Perturbation-based balance training (PBBT) enhances balance recovery strategies.
• Motor learning principles, specifically practice schedules, are emerging in PBBT design.

Purpose of the Study:

• To compare the effects of blocked versus random PBBT on reactive balance control in DPN.
• To assess the persistence and transferability of balance improvements after PBBT.
• To investigate how different practice schedules influence balance recovery in DPN.

Main Methods:

• Individuals with DPN were randomized into blocked PBBT, random PBBT, or control groups.
• Training involved single-session, unexpected platform perturbations (anterior/posterior) at varying difficulty levels.
• Blocked PBBT involved repeating perturbations within blocks; random PBBT used unpredictable sequences.
• Outcomes included center of pressure, reaction time, movement time, and total response time, assessed pre- and post-intervention.

Main Results:

• Blocked PBBT demonstrated superior improvements in reactive balance control compared to random PBBT.
• Balance improvements showed persistence one day after the intervention.
• The study provides insights into the effectiveness of different PBBT practice schedules.

Conclusions:

• Blocked PBBT is a more effective practice schedule than random PBBT for improving reactive balance control in DPN.
• The benefits of PBBT are retained for at least 24 hours post-intervention.
• Findings support the application of motor learning principles in designing balance training for DPN.